“We wouldn’t even be talking about an epidemic today,” said Laurie Garrett, senior fellow for global health at the Council of Foreign Relations, if the kind of response Obama is about to outline had been unveiled in March. “My overriding concern is that it’s coming awfully late in the game.”
The 3,000 U.S. troops will establish a command center in Monrovia, the capital of Liberia, and 17 treatment centers with 100 beds each will be built under Obama’s plan. But Garrett said she’s worried about how long it will take to get the centers up and running and to get supplies to West Africa. The soldiers aren’t expected to be on the ground in Liberia for another few weeks.
“I’m fearful that the mobilization -- all of it will take a lot of time,” she said. “Almost none of this will be operational until the month of October.”
Other questions remain, including who will staff the new hospitals and whether there are enough infectious disease experts willing to go to West Africa to help. The U.S. has said the military will not be in charge of the response, and local African governments are too weak institutionally and politically to lead, Garrett said.
“The overall problem is that we’re all making it up as we go,” she said. “The countries themselves still have to be in charge.”
Dr. Dan Kelly, an infectious disease specialist at the University of California, San Francisco, who has been in Sierra Leone, said 3,000 soldiers is insufficient and there should be more focus on restoring clinics and building up West Africa’s health care infrastructure. He estimated that there will “easily” be 20,000 infections before the outbreak is controlled.
“Clearly, it’s too little, too late, but ultimately we will contain it. It’s a matter of how many lives are lost in the mix,” he said, adding it’s unclear how much Obama’s plan will “change the course of the epidemic.”
“Nobody knows where the end point is going to be,” he said. Some estimates predict the number of Ebola cases could reach 100,000, and Garrett said it may be a year before the virus is contained.
Still, Kelly applauded Obama for tackling the problem. He said the president’s action may spur other governments to follow suit. “This is certainly a game-changer that Obama has committed such an unprecedented commitment to a global health crisis,” he said.
Dr. William Schaffner, professor of preventive medicine and an infectious disease specialist at the Vanderbilt University School of Medicine, also predicted that Obama’s leadership will lead to further commitments to fight Ebola.
“He’s become the orchestra leader of an orchestrated response,” Schaffner said. “The president is really acting forcefully in his role as commander-in-chief.”
Obama’s plan aims to improve the mortality rate of Ebola sufferers by boosting clinical services, which will also improve general public health in West Africa, according to Schaffner. "When patients are cared for by family members, it energizes the epidemic," he said.
He said it’s hard to say what actions could have been taken earlier to stave off the epidemic.
“I think it’s a strongly important commitment, it’s a huge commitment. We can kvetch about whether it’s too late -- that’s not the point,” Schaffner said.